Medicaid is a state and federal program that provides medical coverage and payment to eligible persons. The Texas Medicaid program strives to improve the health of Texas who might otherwise go without medical care and treatment. To qualify for Texas Medicaid, the individual must be a Texas resident, a U.S. national, citizen, permanent resident, or legal alien who needs insurance assistance/health care and whose financial situation is characterized as low income. Further, the person must also be:
- Pregnant, or
- Be responsible for someone 18 years old or younger, or
- Blind, or
- Have a disability or reside with a family member with a disability.
- Be 65 years old or older.
The government sets household income standards that vary depending on the number of people who reside in the home.
Medicaid Estate Recovery Program
Texas maintains a Medicaid Estate Recovery Program (“MERP”) to assist in paying for these services. Under this program, the state reserves the right to recoup the money they provided by recovering money from the person’s estate after they die.
MERP affects the estate of those who received long-term care services after they turned 55, and only if they applied for the service after March 1, 2005. MERP applies to services such as those provided by:
- Nursing facilities
- Intermediate Care Facilities for those with intellectual disabilities or related conditions
- Medicaid waiver programs such
- Community Attendant Services
- Community-Based Alternatives
- Community Living Assistance and Support Services
- Texas Home Living
The program affects several other Medicaid waiver programs and certain hospital services.
Where Does MERP Recover Funds From?
Under MERP, the government may recoup funds from a person’s estate. To accomplish this, the state sends a notice to the decedent’s personal representative or their heirs to notify them of their intent to recover. MERP does not affect all property a person may own. For instance, Texas will not collect on life insurance policies that name a person and bank accounts that are paid on death to another person.
In certain situations, the state may not ask for anything back and will never ask for more money back than it paid for services. Further, the state will not ask for money back in other situations such as when:
- A spouse is still alive.
- There is a child under 21 years old.
- There is a child who is permanently and totally disabled under Social Security standards.
- The estate’s value is $10,000 or less
- The cost of disposing of the property is more than the property’s value.
Further, the state should not ask for money back when it could result in an undue hardship.
Negotiating or Refuting MERP Claims
Receiving notice of a MERP claim can be overwhelming and cause undue financial and emotional worry. An attorney can help families dispute or negotiate MERP claims. Further, a Texas estate planning attorney can develop plans to avoid probate for a house and potentially avoid enforcement of a MERP claim.
Texas MERP Claim Attorneys
An elder law attorney at McCulloch Miller, PLLC. can help you determine your rights and remedies after receiving notice of a MERP claim. In addition, our attorneys have significant experience assisting and representing Texans in their estate planning and probate matters. IN addition to MERP claims, our office handles asset protection, veterans benefits, Medicaid planning, special needs planning, and charitable planning. Contact our office at 713-936-9073 to schedule a free initial consultation with an attorney on our team.